目的 探讨果糖二磷酸钠注射液联合硫酸氢氯吡格雷片治疗急性心肌梗死的临床疗效。方法 选择2019年6月—2020年6月在安阳市人民医院治疗的118例急性心肌梗死患者，根据用药的差别分为对照组（59例）和治疗组（59例）。对照组口服硫酸氢氯吡格雷片，起始剂量为300 mg/次，然后75 mg/次，2次/d；治疗组在对照组的基础上静脉滴注果糖二磷酸钠注射液，100 mL/次，1次/d。两组患者均治疗2周。观察两组患者临床疗效，比较治疗前后两组患者心功能指标左心室射血分数（LVEF）、左心室收缩末期内径（LVESD）、左心室收缩末期容积（LVESV）、左室舒张末期内经（LVEDD），血清学指标心肌肌钙蛋白T（cTnT）、基质金属蛋白酶-9（MMP-9）、类胰岛素生长因子-1（IGF-1）、N端脑钠肽前体（NT-proBNP）和心肌营养素-1（CT-1）水平，及QRS积分和心肌梗死面积。结果 经治疗，对照组总有效率为83.05%，显著低于治疗组的98.31%（P<0.05）。治疗后，两组LVEDD、LVESV和LVESD明显降低，而LVEE明显升高（P<0.05），且治疗组好转程度最明显（P<0.05）。治疗后，两组cTnT、NT-proBNP和MMP-9明显降低，而CT-1和IGF-1明显升高（P<0.05），且治疗组好转最明显（P<0.05）。治疗后，两组QRS积分、心肌梗死面积都明显减小（P<0.05），且治疗组减小程度最明显（P<0.05）。结论 果糖二磷酸钠注射液联合硫酸氢氯吡格雷片治疗急性心肌梗死可有效改善患者心功能，降低机体炎症反应，保护受损的心肌细胞，降低心肌重塑风险。

Objective To investigate the clinical efficacy of sodium fructose diphosphate combined with clopidogrel hydrogen sulphate in treatment of acute myocardial infarction. Methods Patients (118 cases) with acute myocardial infarction in the People’s Hospital of Anyang City from June 2019 to June 2020 were divided into control (59 cases) and treatment (59 cases) groups based on different treatments. Patients in the control group were po administered with Clopidogrel Hydrogen Sulphate Tablets, and the initial dose was 300 mg/time, then 75 mg/time, twice daily. Patients in the treatment group were iv administered with Sodium Fructose Diphosphate Injection on the basis of the control group, 100 mL/time, once daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacy was evaluated, and the cardiac function indexes of LVEDD, LVESV, LVESD, and LVEE, the serum levels of cTnT, NT-proBNP, MMP-9, CT-1 and IGF-1, and QRS scores and myocardial infarct area in two groups before and after treatment were compared. Results After treatment, the effective rate of the control group was 83.05%, which was significantly lower than 98.31% in the treatment group (P<0.05). After treatment, LVEDD, LVESV, and LVESD in the two groups were significantly decreased, while LVEE were significantly increased (P<0.05), and the improvement in the treatment group was most obviously improved (P<0.05). After treatment, cTnT, NT-proBNP and MMP-9 in the two groups were significantly decreased (P<0.05), while CT-1 and IGF-1 were significantly increased (P<0.05), and the improvement in the treatment group was most obviously improved (P<0.05). After treatment, the QRS score and myocardial infarction area in two groups were significantly decreased (P<0.05), especially in the treatment group (P<0.05). Conclusion Sodium fructose diphosphate combined with clopidogrel hydrogen sulphate in treatment of acute myocardial infarction can effectively improve cardiac function, reduce the inflammatory response, protect damaged cardiomyocytes, and reduce the risk of myocardial remodeling.

R972